获得性长QT间期综合征12例临床分析

Clinical analysis of 12 cases acquired long QT syndrome

目的探讨获得性长QT间期综合征的诊断及治疗经验。方法对12例获得性长QT间期综合征临床患者,对其临床特征、心电图特点及临床预后情况进行分析总结。结果 12例获得性长QT间期综合征均有不同的诱因,10例有低钾血症,2例低钾血症同时使用胺碘酮治疗,4例窦性心动过缓,1例Ⅲ度房室传导阻滞;心电图均有QTc间期延长,并有特征性改变;11例患者使用电复律治疗,所有患者均使用硫酸镁及氯化钾治疗,6例患者使用异丙肾上腺素治疗,1例患者使用起搏器治疗,均获得满意疗效。结论掌握获得性长QT间期综合征的临床特征,心电图特点,早期诊断,去除诱因,综合治疗(包括电复律、补钾及镁、提高心室率等),12例患者均获临床治愈。

Objective To explore the diagnosis and treatment experience of the acquired long QT syndrome. Methods Among the 12 cases of acquired long QT syndrome patients, their clinical characteristics , ECG characteristics and clinical outcome were analyzed and summarized. Results There were different incentives in these 12 cases acquired long QT syndrome patients. There were 10 patients of hy- pokalemia, 2 cases of hypokalemia who were still treated with amiodarone, 4 cases of sinus bradycardia, and 1 case of third degree atrioven- tricular block. All these patients had QTc prolongation with characteristic changes in ECG; there were 11 patients treated with electrical car- dioversion, 6 patients treated with isoproterenol, and one patient treated with pacemaker. All patients received magnesium sulfate and potassium chloride treatment at the same time. Successful and satisfactory results were obtained. Conclusion Through grasping the clinical features and ECG characteristics of acquired long QT syndrome, the 12 patients are early diagnosed and clinically Cured with the removal of incentives and comprehensive treatment, including electrical eardioversion, supplying potassium, and increasing ventricular rate.